Case Report

Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case

Table 1

Laboratory workup of thrombocytopenia.

TestResultReference range

Complete blood count
 White blood cells × 109/L6.144–11,000
 Hemoglobin (g/dL)14.512.0–16.0
 Hematocrit (%)43.035.0–47.0
 Platelets × 103/L1150–450
Complete metabolic panel
 Sodium (mmol/L)141136–145
 Potassium3.43.4–4.8
 Chloride10598–107
 Bicarbonate2323–31
 Blood urea nitrogen (mg/dL)1310–20
 Creatinine1.00.6–1.1
 Calcium8.88.5–10.5
 Alkaline phosphatase (U/L)5340–150
 AST (U/L)30<35 U/L
 ALT (U/L)46<55 U/L
 Total bilirubin (mg/dL)0.70.3–1.2
Miscellaneous
 Hepatitis B surface antigenNegativeNegative
 Hepatitis B core total antibodyNegativeNegative
 Hepatitis C antibodyNegativeNegative
 Hepatitis C viral loadNegativeNegative
 HIV 1/2 antibodies and antigenNegativeNegative
 Vitamin B-12 (pg/mL)434210–815
 Folate (ng/mL)9.87.0–31.0
 Lactate dehydrogenase (U/L)221125–250
 Haptoglobin (mg/dL)13730–200
 Reticulocyte count (%)1.710.70–2.50
Reticulocyte count absolute0.07
 Immature reticulocyte fraction10.61–100
 Fibrinogen (mg/dL)365150–400
 D-dimer (ng/mL)<150<243
 Protime (sec)11.99.0–13.0
 Partial thromboplastin time (sec)32.825.0–38.5
 Thyroid-stimulating hormone4.450.45–4.50
 Antinuclear antibodyNegativeNegative
 Helicobacter pyloriNegativeNegative
 Parvovirus B19 Ab, IgGPositiveNegative
 Parvovirus B19 Ab, IgMNegativeNegative
 Epstein–Barr virus (EBV) capsid IgM<0.2<0.9
 EBV capsid IgG>8.0<0.9
 EBV heterophile IgM<0.2<0.9
 EBV viral loadNegativeNegative
 IgA (mg/dL)249.063.0–484.0
 IgG (mg/dL)838.0540.0–1,822.0
 IgM (mg/dL)357.022.0–240.0